Biodegradable stent

ABSTRACT

The present invention is directed to stents that are formed into a helical structure having a plurality of coils, a longitudinal axis, an internal longitudinal passage, a distal section and a proximal section having different diameters; where the structure is made from a fiber having a cross-section and including an inner core having an exterior surface made from a biodegradable polymer having a first degradation rate and an outer section made from a blend of a first biodegradable polymer component and a second biodegradable polymer component covering the exterior surface of the inner core and having a second degradation rate; where the second degradation rate is lower than the first degradation rate.

This application is a continuation-in-part which claims the benefit ofnon-provisional pending U.S. patent application Ser. No. 10/256,942,filed Sep. 27, 2002, which is a continuation of U.S. patent applicationSer. No. 09/933,059, filed Aug. 20, 2001, now U.S. Pat. No. 6,537,312,issued Mar. 25, 2003, which is a continuation of U.S. patent applicationSer. No. 09/470,619, filed Dec. 22, 1999, now U.S. Pat. No. 6,338,739,issued Jan. 15, 2002, which is hereby incorporated by reference herein.

FIELD OF THE INVENTION

The field of art to which this invention relates is medical devices, inparticular, stent devices made from biodegradable polymers.

BACKGROUND OF THE INVENTION

The use of stent medical devices, or other types of endoluminalmechanical support devices, to keep a duct, vessel or other body lumenopen in the human body has developed into a primary therapy for lumenstenosis or obstruction. The use of stents in various surgicalprocedures has quickly become accepted as experience with stent devicesaccumulates, and the number of surgical procedures employing themincreases as their advantages become more widely recognized. Forexample, it is known to use stents in body lumens in order to maintainopen passageways such as the prostatic urethra, the esophagus, thebiliary tract, intestines, and various coronary arteries and veins, aswell as more remote cardiovascular vessels such as the femoral artery,etc. There are two types of stents that are presently utilized:permanent stents and temporary stents. A permanent stent is designed tobe maintained in a body lumen for an indeterminate amount of time.Temporary stents are designed to be maintained in a body lumen for alimited period of time in order to maintain the patency of the bodylumen, for example, after trauma to a lumen caused by a surgicalprocedure or an injury. Permanent stents are typically designed toprovide long-term support for damaged or traumatized wall tissues of thelumen. There are numerous conventional applications for permanent stentsincluding cardiovascular, urological, gastrointestinal, andgynecological applications.

It is known that permanent stents, over time, become encapsulated andcovered with endothelium tissues, for example, in cardiovascularapplications. Similarly, permanent stents are known to become covered byepithelium, for example, in urethral applications.

Temporary stents, on the other hand are designed to maintain thepassageway of a lumen open for a specific, limited period of time, andpreferably do not become incorporated into the walls of the lumen bytissue ingrowth or encapsulation. Temporary stents may advantageously beeliminated from body lumens after a predetermined, clinicallyappropriate period of time, for example, after the traumatized tissuesof the lumen have healed and a stent is no longer needed to maintain thepatency of the lumen. For example, temporary stents can be used assubstitutes for in-dwelling catheters for applications in the treatmentof prostatic obstruction or other urethral stricture diseases. Anotherindication for temporary stents in a body lumen is after energyablation, such as laser or thermal ablation, or irradiation of prostatictissue, in order to control post-operative acute urinary retention orother body fluid retention.

It is known in the art to make both permanent and temporary stents fromvarious conventional, biocompatible metals. However, there are severaldisadvantages that may be associated with the use of metal stents. Forexample, it is known that the metal stents may become encrusted,encapsulated, epithelialized or ingrown with body tissue. The stents areknown to migrate on occasion from their initial insertion location. Suchstents are known to cause irritation to the surrounding tissues in alumen. Also, since metals are typically much harder and stiffer than thesurrounding tissues in a lumen, this may result in an anatomical orphysiological mismatch, thereby damaging tissue or eliciting unwantedbiologic responses. Although permanent metal stents are designed to beimplanted for an indefinite period of time, it is sometimes necessary toremove permanent metal stents. For example, if there is a biologicalresponse requiring surgical intervention, often the stent must beremoved through a secondary procedure. If the metal stent is a temporarystent, it will also have to be removed after a clinically appropriateperiod of time. Regardless of whether the metal stent is categorized aspermanent or temporary, if the stent has been encapsulated,epithelialized, etc., the surgical removal of the stent will resultinglycause undesirable pain and discomfort to the patient and possiblyadditional trauma to the lumen tissue. In addition to the pain anddiscomfort, the patient must be subjected to an additional timeconsuming and complicated surgical procedure with the attendant risks ofsurgery, in order to remove the metal stent.

Similar complications and problems, as in the case of metal stents, maywell result when using permanent stents made from non-absorbablebiocompatible polymer or polymer-composites although these materials mayoffer certain benefits such as reduction in stiffness.

It is known to use bioabsorbable and biodegradable materials formanufacturing temporary stents. The conventional bioabsorbable orbioresorbable materials from which such stents are made are selected toabsorb or degrade over time, thereby eliminating the need for subsequentsurgical procedures to remove the stent from the body lumen. In additionto the advantages attendant with not having to surgically remove suchstents, it is known that bioabsorbable and biodegradable materials tendto have excellent biocompatibility characteristics, especially incomparison to most conventionally used biocompatible metals. Anotheradvantage of stents made from bioabsorbable and biodegradable materialsis that the mechanical properties can be designed to substantiallyeliminate or reduce the stiffness and hardness that is often associatedwith metal stents, which can contribute to the propensity of a stent todamage a vessel or lumen.

However, there are disadvantages known to be associated with the use ofbioabsorbable or biodegradable stents. The disadvantages arise from thelimitation of the material from which the stent is made. One of theproblems associated with the current stents is that the materials breakdown too quickly. This improper breakdown or degradation of a stent intolarge, rigid fragments in the interior of a lumen, such as the urethra,may cause obstruction to normal flow, such as voiding, therebyinterfering with the primary purpose of the stent in providing lumenpatency. Alternatively, they take a long time to breakdown and stay inthe target lumen for a considerable period of time after theirtherapeutic use has been accomplished. There is thus a long-term riskassociated with these materials to form stones when implanted in a urineenvironment, for example, the urethra.

Accordingly, there is a need in this art for novel, temporary stentsmade from biodegradable polymers, wherein the stents remain functionalin a body lumen for the duration of a prescribed, clinically appropriateperiod of time to accomplish the predetermined therapeutic purpose, and,then degrade without breaking down into large, rigid fragments, whichmay cause irritation, obstruction, pain or discomfort to the patient.

In a preferred embodiment of the present invention, the temporary stentreadily passes out of the body as very soft particles or soft fibrouselement or elements, and irritation, obstruction, pain or discomfort tothe patient is either eliminated, or if present, is minimal.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a stent forinsertion into a body lumen which is manufactured from biodegradablepolymers, and which is easily passed from the body lumen after aspecific therapeutic period of time.

It is a further object of the present invention to provide abiodegradable polymeric composition that can be used to make suchtemporary stents, and that would degrade, breakdown and pass out of thebody lumen causing little or no irritation, obstruction, pain anddiscomfort without being substantially absorbed in the body.

It is yet a further object of the present invention to provide a stentmade from a member having an inner core having a first in vivodegradation rate and an outer layer having a second in vivo degradationrate.

Therefore, an implantable stent is disclosed for use in body lumens,wherein such lumens exist as part of the natural anatomy or are madesurgically. The stent is an elongate, hollow member such as a tubularstructure or a helical structure, and in a preferred embodiment has ahelical structure having a plurality of coils made from a wound fiber.The stent has a longitudinal axis and a longitudinal passage. The coilshave a pitch. The helical stent is made from a filament or a fiberhaving an inner core. The inner core has an exterior surface.Optionally, the inner core is hollow. The filament or fiber also has anouter layer, coating or structure covering the exterior surface of theinner core. The filament or fiber has a cross-section. The rates ofdegradation of the inner core and outer layer are selected such that therate of degradation of the inner core is faster than the degradationrate of the outer layer. This effectively provides that the inner coredegrades in vivo, and loses it's mechanical integrity and issubstantially eliminated from the lumen prior to the degradation of theouter layer, while the outer layer remains in place. The inner core ismade from a biodegradable polymer made from the monomers selected fromthe group consisting of lactide, glycolide, paradioxanone, caprolactone,and trimethylene carbonate, caprolactone, blends thereof and copolymersthereof. Again, an important characteristic of the material with is usedto make the inner core is that it has a first degradation rate and thatthis degradation rate is higher or faster than the degradation rate ofthe outer layer having a second degradation rate.

The outer layer or outer structure comprises a blend of at least twopolymers or co-polymers. The blend will contain at least one fasterdegrading polymer and one slower degrading polymer. More specifically,the outer layer or outer shell, comprises a blend of at least twopolymers, the first of said polymers being a glycolide-rich,lactide/glycolide copolymer containing at least 80 mole percent ofpolymerized glycolide, the other of said polymers being a lactide-richcopolymer containing at least 50 mole percent of polymerized lactide.The overall blend contains at least 50 weight percent of theglycolide-rich copolymer and at least 5 weight percent of lactide-richcopolymer with, preferably, the overall blend containing about 38 toabout 97 weight percent of polymerized glycolide.

Preferably, the outer layer or outer shell comprises a blend of at leasttwo polymers, the first of said polymers being, a glycolide-rich,lactide/glycolide copolymer containing at least 80 mole percent ofpolymerized glycolide, and another of said polymers being alactide-rich, lactide/glycolide copolymer, containing at least 50 molepercent of polymerized lactide. The polymeric components of the overallblend (that is, not counting non-polymeric components such as bariumsulfate) will contain at least 50 weight percent of the glycolide-richcopolymer and at least 20 weight percent of lactide-rich copolymer withthe overall blend containing about 38 to about 89 weight percent ofpolymerized glycolide and the rest being polymerized lactide.

Most preferably, the outer layer or outer shell, comprises a blend of atleast two polymers, the first of said polymers being the glycolide-richcopolymer, 10/90 lactide/glycolide copolymer, the second of saidpolymers being the lactide-rich copolymer, 85/15 lactide/glycolidecopolymer. The polymeric components of the overall blend (that is, notcounting non-polymeric components such as barium sulfate) will containabout 60 weight percent of the glycolide-rich copolymer (10/90lactide/glycolide copolymer) and about 40 weight percent of thelactide-rich copolymer (85/15 lactide/glycolide copolymer), with theoverall blend containing about 60 weight percent of polymerizedglycolide and about 40 polymerized lactide.

The inner core typically degrades by hydrolysis and breaks down at afaster rate than the outer layer with exposure to body fluids. The innercore breaks down into small granular particles that are removed easilyby the body fluids. The outer layer degrades or erodes into a fibrillarmorphological structure. The faster degrading core, after sufficient invivo exposure, possesses little or no mechanical integrity and is slowlyremoved, reducing the stent cross-section from a solid to a softstructure that increasingly appears to be hollow. With hydrolyticexposure, the progressively degrading stent can readily pass out of thebody lumen, thereby minimizing the possibility of causing obstruction,pain or discomfort. Both the inner core and outer shell althoughdegradable, do not bio-absorb and their degradation products are passedthrough and out of the body lumen. In one embodiment of the presentinvention, the device is rendered soft and pliable in vivo, therebyallowing it to easily pass out of the lumen in substantially a unitarypiece. In another embodiment, the device not only is rendered soft andpliable, it breaks down into smaller discrete non-occluding pieces thatpass out of the lumen.

Yet another aspect of the present invention is the above-described stentmade from a fiber that is radio-opaque.

Still yet another aspect of the present invention is the above-describedstent having only the outer layer without the inner core.

Another aspect of the present invention is the above-described fiberused to make a stent having a helical structure.

Yet another aspect of the present invention is a method of using thestents of the present invention in a surgical procedure to maintain thepatency of a body lumen. A stent of the present invention is provided.The stent is an elongate, hollow member and in a preferred embodimenthas a helical structure having a plurality of coils. The member has alongitudinal axis. The coils have a pitch. The structure is made from afilament or a fiber having an inner core. The inner core has an exteriorsurface. Optionally, the inner core is hollow. The filament or fiberalso has an outer layer covering substantially all of the exteriorsurface of the inner core. The filament or fiber has a cross-section.The rates of degradation of the inner core and outer layer are selectedto effectively provide in a preferred embodiment such that the rate ofdegradation of the inner core is higher than the degradation rate of theouter layer to effectively provide that the inner core degrades in vivo,and loses it's mechanical integrity and is substantially removed fromthe lumen prior to elimination of the degradation of the outer layer.The inner core typically degrades by hydrolysis and breaks down at afaster rate than the outer layer with exposure to body fluids; the outerlayer degrades or erodes into a soft, fibrous morphology. The stent isinserted into the body lumen of a patient, thereby providing for thepatency of the lumen for a specific range of times. The stent ismaintained in the lumen for a sufficient period of time to effectivelymaintain the lumen open and to effectively let the inner core degradesuch that the softened outer core may be passed through the lumen.

Still yet another aspect of the present invention are theabove-described stents and fibers, wherein the slower degradingpolymeric blend is used for the core, and the faster degrading polymericmaterial is used as the outer layer or structure.

These and other aspects of the present invention will become moreapparent from the following description and examples, and accompanyingdrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a preferred embodiment of a stent deviceof the present invention mounted to the distal end of an applicatorinstrument.

FIG. 2 is a perspective view of the stent and applicator of FIG. 1,prior to loading the stent onto the applicator instrument.

FIG. 3 is a side view of a stent device of the present invention, havinga helical configuration.

FIG. 4 is a cross-sectional view of the fiber used to make the stent ofFIG. 3 taken along View Line 4-4 illustrating an oval cross section.

FIG. 5 is a side view of the stent and applicator device of FIG. 1,where the device is shown in the ready position, prior to application.

FIG. 6 is a side view of the stent and applicator device of FIG. 5,illustrating the position of the stent relative to the applicator whenthe stent is partially deployed by engaging the applicator trigger.

FIG. 7 illustrates the relative positions of the stent to the applicatorof FIG. 6 when the stent is fully deployed by fully engaging theapplicator trigger.

FIG. 8 illustrates the stent of the present invention fully deployed inthe urethra and prostate of a patient, providing for a patent lumen.

FIG. 9 illustrates a stent of the present invention emplaced in theurethra of a patient after the inner core has broken down and shows thestent being excreted from the body as an elongated soft strand or numberof elongated soft strands.

FIG. 10 illustrates an alternative embodiment of a stent of the presentinvention wherein a double fiber is used to make the stent.

FIG. 11 is a cross-sectional view of the stent of FIG. 10 taken alongView Line 11-11; the fibers are seen to have a circular cross-section.

FIG. 12 is a perspective view of an alternate embodiment of a stent ofthe present invention, wherein the stent has a tubular configuration.

FIG. 13 is a cross-sectional view of the stent of FIG. 12 taken alongView Line 13-13.

FIG. 14 is a perspective view of an alternate embodiment of a stent ofthe present invention having a tubular configuration with latticedopenings.

FIG. 15 is an end view of a fiber of the present invention having ahollow passageway through the inner core.

FIG. 16 is a graph of Yield Loads vs Days In Vitro of coextruded fiberswith an overall diameter of 1 mm (40 mils) and an outer shell thicknessof 0.2 mm (8 mils). Fiber 1 has an outer layer composed from a blendcontaining 60 weight percent of a copolymer of 90 mole % glycolide and10 mole % of lactide and 40 weight percent of a second copolymer of 15mole % glycolide and 85 mole % of lactide. The inner layer of Fiber 1 iscomposed from a blend of 95 weight percent of a copolymer of glycolideand caprolactone and 5 weight percent of barium sulfate. Fiber 2 has anouter layer composed from a copolymer of 90 mole % glycolide and 10 mole% of lactide. Inner layer of Fiber 2 is composed from a blend of weightpercent of a copolymer of glycolide and caprolactone and 5 weightpercent of barium sulfate.

FIG. 17 is a graph of Yield Strain vs Days In Vitro of coextruded fiberswith an overall diameter of 1 mm (40 mils) and an outer shell thicknessof 0.2 mm (8 mils). Fiber 1 has an outer layer composed from a blendcontaining 60 wt % of a copolymer of 90 mole % glycolide and 10 mole %of lactide and 40 wt % of a second copolymer of 15 mole % glycolide and85 mole % of lactide. Inner layer of Fiber 1 is composed from a blend of95 wt of a copolymer of glycolide and caprolactone and 5 wt % of bariumsulfate. Fiber 2 has an outer layer composed from a copolymer of 90 mole% glycolide and 10 mole % of lactide. Inner layer of Fiber 2 is composedfrom a blend of 95 wt of a copolymer of glycolide and caprolactone and 5wt % of barium sulfate.

FIG. 18 is a side view of a schematic of a stent with criticaldimensions referred to in Example 3.

FIG. 19 is a schematic of a mandrel used to manufacture stents inExample 3.

FIGS. 20A-C illustrates electron microscope photographs discussed inExample 6.

FIG. 21A is a perspective view of a stent having distal and proximalsections of different diameters.

FIG. 21B is a view of a stent having distal and proximal sections ofdifferent diameters as shown from the distal end.

FIG. 21C is a side view of a stent having distal and proximal sectionsof different diameters.

FIG. 22 illustrates a stent of the present invention fully deployed inthe urethra and prostate of a patient, providing for a patent lumen.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to FIGS. 1-9, a preferred embodiment of a stent of the presentinvention is illustrated. As seen in FIG. 3, the stent 10 is seen to bea helical structure having a series of connected coils 20. The coils aremade from fiber 100. The term fiber as used herein is defined to includenot only fibers but filaments as well. It is preferred that fiber 100 bea continuous fiber, however, it is possible to make stent 10 from two ormore sections of fiber which are subsequently connected or hingedtogether. As seen in FIG. 4, the fiber 100 is seen to have inner core110 and outer layer or covering 130. The inner core 110 is seen to haveouter surface 115. Covering the outer surface 115 of inner core 110 isthe outer layer or section 130. Outer layer 130 is seen to have innersurface 135 and exterior surface 140. Preferably, inner surface 135 isin contact with, and affixed to, the outer surface 115. The outer layer130 is referred to herein as a structure, layer or coating. For example,it may be coated onto core 110, coextruded with core 110, orsubsequently mounted or affixed onto core 110. The stent is seen to havea longitudinal axis 70, and internal passageway 11. The stent 10 is seento have a first distal section 30 of coils 20 connected to a secondsection 50 of coils 20, wherein the sections 30 and 50 are connected byhinged connecting fiber 60. The distal section 30 of coils adjacent tohinged connecting fiber 60 forms an anchoring section which is inserteddistal to the external sphincter. The proximal section 50 of the stent10 is maintained within the prostatic urethra. Proximal section 50 isseen to have coils 20 having diameter 24, and also has passageway 51.The distal section 30 of stent 10 has coils 20 having a diameter 22.Distal section 30 also has a passageway 31. Passageways 31 and 51 are incommunication to form passageway 11 of stent 10.

As seen in FIGS. 21A-C, in another embodiment of the present invention,stent 40 is seen to be a helical structure having a series of connectedcoils 42. Stent 40 is seen to have a first distal section 46 of coils 42and a second proximal section 44 of coils 42. Distal section 46 of stent40 forms an anchoring section which is inserted proximal to the externalsphincter and which is maintained within the prostatic urethra. Proximalsection 44 of the stent 40 similarly is placed and maintained within theprostatic urethra. Proximal section 44 has a diameter 45 and distalsection 46 has a diameter 47. Diameter 45 is less than diameter 47.

As seen in FIG. 4, one preferred embodiment of stents 10 and 40 of thepresent invention has a fiber 100 having an oval cross-sectionalconfiguration. The fiber 100 may have various configurations dependingupon the application including round, square, polygonal, curved, oval,and combinations thereof and equivalents thereof. Those skilled in theart will appreciate that certain cross-sectional configurations willprovide different advantages in the stent. For example, the advantagesof fiber of the present invention having an oval cross-section includeease of the stent manufacturing process due to a possible on-line,one-step transition from the fiber to the stent in future manufacturingprocesses, flexibility during the stent deployment by being able totailor the length of the stent during a surgical procedure to fit aparticular patient's anatomy, and possible enhanced mechanicalcapabilities. Additionally, the core sections of the oval fibers aresusceptible to faster degradation than the round fibers leading to amore palpable degradation product. A softer degradation product will beless irritable and cause less discomfort during ultimate passage. Ifdesired, the fiber 100 may additionally have a hollow longitudinalpassageway as illustrated in FIG. 15, wherein a fiber 800 has an outerlayer 810, an inner core 820, and a hollow longitudinal passage 830within core 820. Another embodiment of a helical stent of the presentinvention is illustrated in FIGS. 10-11. The stent 700 is seen to bemade from double fibers 710 having inner cores 712 and outer cores 715.The stent is seen to have a plurality of coils 720, first section 730and second section 740 joined by hinged connecting section 750. Thestent 700 is seen to have longitudinal passage 702. The fibers 710 havea circular cross-section and are preferably connected together atseveral locations along the length of each fiber.

Another embodiment of a stent of the present invention is seen in FIG.12. The stent 500 is seen to have a tubular configuration having ends510 and 520, as well as inner passageway 530 in communication withopenings 511 and 521 in ends 510 and 520, respectively. The stent isseen to have inner core section 540 and outer layer or structure 550. Ifdesired, the stent 500 may have a variety of conventionally shapedopenings 590 extending through the outer structure 550 and inner core530, arranged in a pattern such as a lattice, as seen in FIG. 14. Ifdesired, the openings 590 can extend only through outer structure 550. Across-sectional view of stent 500 is illustrated in FIG. 13, where theinner core section 540 and the outer layer or structure 550 can bereadily seen.

Although not particularly preferred, the stents of the present inventioncan be manufactured from fibers without an inner core. That is, thefibers would only have the degradable outer layer without the innercore. Such fibers could be solid, or could have a hollow passageway.Similarly, if a tubular configuration were desired, it could be madewith no inner core, while having a hollow passageway and would be madeentirely from the polymeric composition used for the outer core.

The stent 10 is preferably manufactured from a bioabsorbable polymericfiber 100 having a desired cross-sectional configuration. The length andoverall diameter of the stent 10 will depend upon a number of factorsincluding the anatomy of the patient, the size of the anatomy and thetype of surgical procedure which has affected the urethral lumen. Forexample, the overall length of a stent 10 useful in the practice of thepresent invention will be sufficient to effectively maintain the lumenpassage open. Typically the length for urethral applications in andadult male, the length will be about 10 mm to about 200 mm, moretypically about 20 mm to about 100 mm, and preferably about 40 mm toabout 80 mm. The diameter of a stent 10 of the present invention will besufficient to effectively maintain patency of the lumen. For certainprostatic urethral applications, the stent has two sections havingdifferent diameters bridging the prostatic urethra and the externalsphincter. Typically, the diameter of the proximal section of the stentplaced in the prostatic urethra will be about 2 mm to about 25 mm, moretypically about 4 mm to about 15 mm, and preferably about 6 mm to about10 mm. The diameter of the distal section of the stent used to anchordistal to the external sphincter will be about 2 mm to about 25 mm, moretypically about 4 mm to about 15 mm, and preferably about 6 mm to about10 mm. In another embodiment of a prostatic urethral application, thestent has two sections having different diameters and the stent isplaced substantially entirely within the prostatic urethra, such thatthe stent is effectively anchored within the prostatic urethra.Preferably, the stent is placed entirely within the prostatic urethra.In such embodiments, the diameter of proximal section of the stent willrange from about 8 mm to about 12 mm, preferably about 8 mm. Thediameter of the distal section of the stent will range from about 6 mmto about 25 mm, preferably about 18 mm. The major cross-sectionaldimension of a fiber used to manufacture a stent of the presentinvention will be sufficient to provide effective support andflexibility. Typically, when utilizing a circular cross-section, thediameter for urethral applications will be about 0.1 mm to about 4 mm,more typically about 0.5 mm to about 3 mm, and preferably about 1 mm toabout 2 mm. The pitch, length, diameter and fiber diameter of the stentsof the present invention will be sufficient to effectively providesufficient support in response to radial stress of the urethral vesselwalls, while providing for ease of insertion and stability whileinserted in the urethral lumen, as well as desired flexibility and lumenpatency. The pitch of the stent is defined to be the number of coils perunit length. In this patent application specification, for this example,pitch is defined as the number of coils per centimeter of stent length.Typically, for urethral applications, the pitch will be about 2.5 toabout 100, more typically about 3 to about 20, and preferably about 5 toabout 10. Although it is preferred for urethral applications that therebe no space between adjacent coils, the stents of the present inventionmay have spaces between adjacent coils.

It is also possible for the stents of the present invention to have inaddition to wound fiber structures, such as tubular members, latticedmembers and the like. Examples of a tubular stent are illustrated inFIGS. 12-14. Those skilled in the art will appreciate that suchstructures could be made from woven cloth, mesh, flat stock that isrolled into shape, and the like. Such structures could have the innercore and outer layer, similar to the fibers and helical stents of thepresent invention, or may simply be made from the blend materials usedto make the outer section.

In addition, it should be noted that an alternate embodiment of thestents and fibers of the present invention is to have the slowerdegrading polymer component as the inner core and the faster degradingpolymer component as the outer section. The faster degrading outer corewould sluff off or degrade over time leaving behind the softening innercore, which would then be expelled or removed from the lumen. Thepolymer components would be the same as for the other embodiments, thatis, for the faster degrading and slower degrading components.

The fibers of the present invention will preferably be made to have aninner core consisting of a first biodegradable polymer composition andan outer core consisting of a second biodegradable polymer composition.The inner polymer core material will be selected such that the innercore will degrade by hydrolysis and lose mechanical integrity at arelatively faster rate than the outer shell upon exposure to body fluidsover time. The inner core material breaks down preferably into smallgranular particles that are removed easily by the body fluids. A portionof the outer polymer coating will be selected to have a relatively slowrate of hydrolysis that would preferably degrade or erode and expose afibrillar morphological structure after in vivo exposure to body fluids.The fibrillar morphology of the outer layer aids the dispersion ofdegradation products of the faster degrading inner core.

The fibrillar morphology of the outer layer is a consequence of thepolymer blend composition and the process conditions used to produce it.The fibrillar morphology allows the outer layer to soften with timerather than break up into large pieces that can cause obstruction orocclusion in the lumen. In a different embodiment of the presentinvention, the fiber is of solid or hollow cross-section preferably withan inner core and an outer layer made from polymer blend.

The slower degrading shell is fibrillar and the faster degrading coreposses no significant mechanical integrity and is slowly removed. Theeffect of the differing degradation profiles and the physical state ofthe degraded polymers reduce the stent cross-section from a solid to asoft structure that increasingly appears to be hollow. The fibrillarstructure will soften over time instead of breaking down into large,sharp fragments that can cause the removal and/or passage of thedegraded stent to be clinically eventful. In a flow environment, theprogressively degrading stent can readily pass through the body lumenwithout causing obstruction, pain or discomfort. Both the inner core andouter shell do not bio-absorb into the lumen wall as their degradationproducts are passed from the body lumen.

A stent must be designed to withstand radial stresses in order toperform its function of maintaining a passage through a lumen open. Themechanical capability of the stents of the present invention towithstand radial stresses when the stent is emplaced in the body lumenis provided primarily by the biodegradable material in the outer shelllayer. The strength, stiffness, and thickness of this material in theouter shell are sufficient to effectively withstand the loads necessaryto keep the stent functional. As the inner core degrades and breaksdown, the outer shell wall having a sufficient thickness of properlyselected biodegradable material would effectively be able to withstandthe load necessary for the time period required to keep the lumenpatent. In essence then, the annular shell can be designed to fulfillthe mechanical requirements of keeping the body lumen patent or open forthe specific therapeutic time period. The inner core, in addition tobeing designed to degrade into small granular-like fragments, can alsobe filled with other conventional materials that can satisfy otherfunctional needs such as a carrier of radio opaque markers or aspotential processing aids during stent manufacturing. For example, afilled core can reduce the “flattening” of the fiber that is sometimespossible when a hollow stent is wound at high temperatures.

A proper selection of degradation rates will cause the inner core tofracture into small pieces in vivo, while a portion, or all, of theouter layer remains intact, thereby producing unique “soft” fragments orfilaments. That is, after the inner core has degraded and effectivelybeen removed from the stent structure by body fluids, the remainingouter layer degrades to a soft, pliable, fibrillar filament, which mayremain intact or degrade into several sections. The remaining softfilament, or pieces thereof, is readily excreted from the lumen.

As mentioned previously, although not preferred, it is possible tomanufacture the stents of the present invention from fibers having noinner core, but only the outer layer material. Such fibers could behollow or solid. Similarly, tubular stents of the present inventioncould also be manufactured without the inner core. When manufacturingsuch embodiments, it would not be necessary to use co-extrusion.Otherwise, the requirements for the stents in terms of mechanicalstrength and degradation rates would be similar.

Polymer materials useful in the stents and fibers of the presentinvention include those biodegradable polymers disclosed in U.S. Pat.No. 4,889,119 which is incorporated by reference. In those embodimentsof the subject invention utilizing an inner core, the inner corecomprises a polymer or polymers having a biodegradation rate higher thanthat of the outer layer or outer shell. The polymers used to manufacturethe inner core will include polymers sufficiently effective tohydrolyze, degrade and breakdown at a relatively faster rate compared tothe material in the shell. Preferably, these polymers include those madeutilizing the monomers of lactide, glycolide, paradioxanone,trimethylene carbonate and caprolactone. When the term “caprolactone” isused herein it is meant to mean epsilon-caprolactone. These monomers canbe used to make copolymers that can have random, block or segmentedblock sequences, or combinations thereof. Of particular utility are thesegmented block copolymers of glycolide and caprolactone containingabout 75 mole % of polymerized glycolide and about 25 mole % ofpolymerized caprolactone. Combinations of copolymers thereof can beemployed.

The polymeric materials used for the outer layer of the stents of thepresent invention are selected from polymers sufficiently effective tohydrolyze, degrade and breakdown at a relatively slower rate andpreferably form a fibrillar morphological structure upon in vivoexposure. Preferably, the polymers which can be utilized to form theouter layer include polylactide, polyglycolide, polyparadioxanone, andpolycaprolactone and combinations thereof, copolymers thereof andequivalents thereof. It is particularly preferred to use a blend of atleast two polymers or co-polymers in the outer shell. The blend willcontain at least one faster degrading polymer and one slower degradingpolymer. It is preferable, though not essential, that there is somecompatibility between the two polymers in the outer shell but also thatthe two components are somewhat immiscible.

For the outer shell, it is particularly preferred to use a blend of aglycolide copolymer containing at least 80 mole percent of polymerizedglycolide, the other of the said polymer being polylactide copolymercontaining at least 50 mole percent of polymerized lactide. The overallblend will contain at least 50 weight percent of the glycolide copolymerand at least 5 weight percent of lactide copolymer with the overallblend containing about 38 to about 97 weight percent of polymerizedglycolide and the rest being polymerized lactide.

The fibers useful in manufacturing the stents of the present inventionhave an inner core of a first biodegradable material having a firstdegradation rate and an outer layer of a second biodegradable materialhaving a second degradation rate can be manufactured using a variety ofconventional techniques including conventional co-extrusion processing.For example, a fiber may be formed by feeding a first polymercomposition to a first pump on a conventional co-extruder, and a secondpolymer composition to a second pump on a conventional co-extruder. Thefirst pump directs the first polymer composition to the interior of aco-extrusion die, while the second pump directs the second polymercomposition to the outer concentric section of the co-extrusion die,thereby forming a fiber having an inner core and an outer layer. Ifdesired, the fibers of the present invention may be made by otherconventional processes including melt coating, solution coating orpowder coating followed by spreading the coating by melting, etc., andthe like. For example, when using a coating process, the inner core canbe a mono-filament extruded material or can be made from amulti-filament braid. The outer shell layer can be added on top of theinner core either by melt coating or solution coating by passing theinner core through a bath, through coating rollers, spraying and/or adie. If it is desired to manufacture the stents of the present inventionas a single tubular structure rather than a wound fiber structure, aco-extrusion process would be utilized and the co-extrusion dies wouldbe selected to produce a tube of an appropriate diameter having a hollowinner core, said core having a sufficiently effective thickness, and anouter layer of a sufficiently effective thickness. Also, the fibersuseful in manufacturing the stents of the present invention can bemanufactured to have a hollow passage through the core if desired.

It is important to recognize that a high-lactide polymer such as 95/5poly(lactide-co-glycolide) can be used to provide excellent initialmechanical properties and excellent retention of those properties withtime. The great disadvantage of utilizing materials such as these(ordinary synthetic absorbable homo- or co-polymers) to form temporarystents is that when devices made from them start to degrade, thesedevices (mechanically) usually fail by way of a catastrophic failuremechanism.

Cracks that initiate, very rapidly propagate causing the article to“break in two”; hence the term “catastrophic failure”. These rapidlypropagating cracks start to develop while the material is stillsubstantially very hard. Thus, when the articles start to degrade theyinitially break into large hard pieces, which then continue to break inmuch smaller pieces. It should be appreciated that unless constrained,the large pieces can migrate and cause severe anatomical and/orbiological consequences prior to degrading into harmless finely dividedparticles. In particular, in the case of temporary stent made fromordinary synthetic absorbable (homo-or) copolymers, these pieces canobstruct of occlude the lumen that the stents were meant to hold open.

Thus utilizing copolymerization of lactide and glycolide (whether in arandom, segmented or block nature—ranging from polyglycolide homopolymerto polylactide homopolymer), a combination of properties, such assuitable initial mechanical properties, suitable excellent retention ofthose properties with time, and softening failure mechanism, is verydifficult if not impossible to achieve.

We have unexpectedly found that the blends described in U.S. Pat. No.4,889,119 meant to produce absorbable plastic surgical fasteners byinjection molding applications, can be utilized to great advantage inproducing fibers, which can be made into biodegradable temporary stents.We have further discovered that fiber of the described blend in the formof a hollow fiber construction, and especially in the form of a fiberhaving an inner core of a second faster degrading material, providesmuch-preferred embodiments of our present invention.

Although we do not wish to be held to any particular scientific theoryor principles, we believe that the blend composition results in amorphology in which the lactide-rich polymers act as a crack arrestor.The cracks that initiate, rather than very rapidly propagating, arearrested. Although these cracks start to develop while the material isstill substantially very hard, because the cracks are not allowed torapidly propagate, the article does not “break in two”. In time, thearticle develops other small cracks; all the while these cracks areprevented from breaking completely through the article by thelactide-rich blend component acting as the “crack arresting” minorphase. This lactide-rich blend component also helps to reinforce thearticle until there are so many cracks that the article softens andharmlessly fails without producing the large, potentially obstruction oroccluding pieces of the prior art.

In another embodiment of the present invention, the polymers and blendsthat are used to form the composite can be used as a drug deliverymatrix. To form this matrix, the polymer would be mixed with atherapeutic agent. The variety of different therapeutic agents that canbe used in conjunction with the polymers of the present invention isvast. In general, therapeutic agents which may be administered via thepharmaceutical compositions of the invention include, withoutlimitation: anti-infectives such as antibiotics and anti-viral agents;analgesics and analgesic combinations; anti-inflammatory agents;hormones such as steroids; bone regenerating growth factors; andnaturally derived or genetically engineered proteins, polysaccharides,glycoproteins, or lipoproteins.

Matrix formulations may be formulated by mixing one or more therapeuticagents with the polymer. The therapeutic agent may be present as aliquid, a finely divided solid, or any other appropriate physical form.Typically, but optionally, the matrix will include one or moreadditives, such as diluents, carriers, excipients, stabilizers or thelike.

The amount of therapeutic agent will depend on the particular drug beingemployed and medical condition being treated. Typically, the amount ofdrug represents about 0.001 percent to about 70 percent, more typicallyabout 0.001 percent to about 50 percent, most typically about 0.001percent to about 20 percent by weight of the matrix. The quantity andtype of polymer incorporated into the drug delivery matrix will varydepending on the release profile desired and the amount of drugemployed.

Upon contact with body fluids, the polymer undergoes gradual degradation(mainly through hydrolysis) with concomitant release of the disperseddrug for a sustained or extended period. This can result in prolongeddelivery (over, say 1 to 5,000 hours, preferably 2 to 800 hours) ofeffective amounts (say, 0.0001 mg/kg/hour to 10 mg/kg/hour) of the drug.This dosage form can be administered as is necessary depending on thesubject being treated, the severity of the affliction, the judgment ofthe prescribing physician, and the like. Following this or similarprocedures, those skilled in the art will be able to prepare a varietyof formulations.

The stents 10 of the present invention when made from fiber aremanufactured in the following manner using a winding process. Aco-extruded fiber is used to wind the stent about a mandrel by heatingthe fiber and then coiling it around the mandrel. The fiber may beheated prior to winding or subsequent to winding about the mandrel usingconventional processes. The assembly of the mandrel and the stent arepreferably annealed under constraint and then the mandrel is removed. Ifdesired, the stent may be annealed after removal from the mandrel. Thepitch and diameter of the coils are selected to provide the desired sizeand shape of stent.

The stents of the present invention may be utilized in the followingmanner in urethral stent placement procedures as illustrated in FIGS. 1,2, 5, 6, 7, 8 and 22. Initially Stent 10 or 40 is placed upon the distalend of an applicator instrument 200. Instrument 200 is seen to havehandle 250 having grip 255. At the top 257 of the handle 250 is mountedthe shaft retention member 290. Retention member 290 is seen to havelongitudinal passageway 292, front 295 and back 296. The mounting tube240 is seen to have distal end 242 and proximal end 244. Mounting tube240 is seen to have passage 248. The proximal end 244 of tube 240 isseen to be mounted in passageway 292 such that the inner passageway 248is in communication with passageway 292. Slidably mounted in passageway248 is the applicator tube 220. Tube 220 has distal end 222, proximalend 224, and passageway 226. Mounted to the proximal end 224 of tube 220is the mounting block 300, which is affixed to end 224 by pin 309.Mounted to the bottom of block 300 is rack gear member 330 having gearteeth 335. Contained in handle 250 is the cavity 350 for receivingpinion gear member 270, having teeth 275. Pinion gear member 270 ispivotally mounted in cavity 350 by pivot pins 265. Teeth 275 mesh withand are engaged by teeth 335. Extending out from pinion gear member 270on the opposite side of pins 265 is the actuation trigger 280. Actuationof trigger 280 will move tube 220 proximally and distally with respectto tube 240. Actuating the trigger 280 will allow the stent 10 to bereleased from the tubes 220 and 240.

The stent and distal end of the instrument 200 are inserted into theurethra 410 through the meatus 400 of the patient's penis as seen inFIGS. 8, 9 and 22. As shown in FIGS. 8 and 9, the distal end of theinstrument 200 and the stent 10 are manipulated through the urethra 410such that the prostatic section of the stent is located within theprostatic urethra 411 and the distal end of the stent is distal to theexternal sphincter 430, thereby providing an open passage for urine frombladder 450 through the lumen of the urethra. As shown in FIG. 22, stent40 may similarly be placed through the urethra 410 such that stent 40 isplaced entirely within prostatic urethra 411, where distal section 46 ofstent 40 provides an anchor within prostatic urethra 411. Then, theapplication instrument 200 is withdrawn from the urethra 410 by engagingtrigger 260 and pulling distally on the instrument, thereby completingthe procedure and providing for an implanted stent 10 which allows forpatency of the urethral lumen 410. As seen in FIG. 9, the stent 10 afterhaving been in place for the appropriate period of time has degraded toa state wherein it is substantially a soft, flexible fragment orfilament, or a number of discrete soft, flexible fragment or filaments,and is readily passed from the urethra 410 out of the patient's bodywith the urine flow. It will be appreciated by those skilled in the artthat placement for other types of body lumens could be done in a similarmanner, with modification as required by the unique characteristics ofthe lumen or of the surgical emplacement procedure.

The following examples are illustrative of the principles and practiceof the present invention, although not limited thereto.

EXAMPLE 1

A material blend was prepared for use in manufacturing the inner coreand outer layer of a fiber useful to wind into a stent of the presentinvention. The use of this material in fiber formation is described inExample 2.

The outer shell layer was constituted from a blend of 60 wt % of a firstrandom copolymer containing 90 mole % of polymerized glycolide and 10mole % polymerized lactide and 40 wt % of a second copolymer containing85 mole % polymerized lactide and 15 mole % polymerized glycolide. Theinherent viscosity of the first copolymer containing 90 mole %polymerized glycolide and 10 mole % polymerized lactide, to behenceforth referred to as 90/10 glycolide/lactide copolymer, was 1.4dL/g as determined in HFIP (hexafluroisopropanol) at 25° C. at aconcentration of 0.1 g/dL. The inherent viscosity of the secondcopolymer containing 85 mole % polymerized lactide and 15 mole %polymerized glycolide, to be henceforth 85/15 lactide/glycolidecopolymer, was 2.1 dL/g as determined in chloroform at 25° C. at aconcentration of 0.1 g/dL. The two copolymers were mixed into a 60/40weight ratio before being finally melt blended and pelletized using an18 mm twin screw extruder with 40:1 L:D, low to medium shear screwconfigurations and proper venting. The temperature profile was 130, 205,205, 210, 210, 210 and 205° C. from rear zone to die flange. The die wasa single orifice rod die with 2.5 mm diameter and the die temperaturewas 200° C. The extrudate from the twin screw was quenched in a waterbath and pelletized. The inherent viscosity of the first blendcontaining polymerized glycolide and polymerized lactide was 1.6 dL/g asdetermined in hexafluroisopropanol at 25° C. at a concentration of 0.1g/dL.

The inner core layer is constituted from a blend containing 95 wt % of asegmented block copolymer of 75 mole % of a polymerized glycolide and 25mole % of polymerized caprolactone and 5 wt % of barium sulfate. Theinherent viscosity of the segmented block copolymer containing glycolideand caprolactone, to be henceforth to be referred to as 75/25glycolide/caprolactone, was 1.5 dL/g as determined inhexafluroisopropanol at 25° C. at a concentration of 0.1 g/dL. Theincorporation of barium sulfate allows the fiber to be radio-opaque. Thetwo components were pre-blended at a required 95/5 weight ratio beforebeing finally melt blended and pelletized using an 18 mm twin screwextruder with 40:1 L:D, low to medium shear screw configurations andproper venting. The temperature profile for compounding the corematerials was 130, 185, 190, 190, 195, 195 and 195° C., from rear zoneto die flange. The die has a single orifice rod die with 2.5 mm diameterand the die temperature was 190° C. The extrudate from the twin screwwas quenched in a water bath and pelletized. The inherent viscosity ofthe second blend containing polymerized glycolide and polymerizedcaprolactone was 1.5 dL/g as determined in hexafluroisopropanol at 25°C. at a concentration of 0.1 g/dL.

EXAMPLE 2

The fabrication method for coextruded fibers with round cross-sectionsfollows. The material used in the inner core and outer layer shell hasbeen described in Example 1 above. The outer shell layer was made from ablend of 60 wt % 90/10 glycolide/lactide copolymer and 40 wt % of 85/15lactide/glycolide copolymer. The inner layer was made from a blend of 95wt % of 75/25 glycolide/caprolactone segmented block copolymer and 5 wt.% Barium Sulfate. Also the in vitro tensile testing of the fibers ispresented and compared to coextruded fibers that have only the 90/10glycolide/lactide copolymer.

The fibers were co-extruded using two single screw extruders. Bothscrews had compression ratios of 3:1 and an l/D of 25:1. A 1″ horizontalextruder was used for outer shell layer and ⅝″ vertical extruder wasused for the inner core. A concentric two-layer feed-block was used tofeed the two material stream into a single orifice die from which theextrudate is fed to a water trough for cooling. An air jet was used toremove the excess surface moisture and an air cutter was used to cutfiber into desired length of approximately 4 feet. A laser-micrometerwas used to measure the fiber diameter (major and minor) on-line and amicroscope was used to ascertain the wall thickness, of the inner andouter layers.

The temperature profile of the material in the outer shell was 185, 210,222, 215, and 215° C. from rear barrel zone to die flange. The blend inthe outer shell was 60 wt % of 90/10 glycolide/lactide copolymer and 40wt % of 85/15 lactide/glycolide copolymer. The temperature profile ofthe inner core material was 215, 224, 224 and 230° C. from rear barrelzone to die flange. The material in the inner core was a blend of 95 wt% 75/25 glycolide/caprolactone segmented block copolymer and 5 wt. %BaSO₄. A single-hole die of circular cross-section at a temperature of213° C. was used.

The in vitro yield load and yield strain of the coextruded round fiber,made by the above mentioned method, are compared in FIGS. 16 and 17 tothat of a coextruded round fiber having a different material compositionin the outer shell. Both fibers are 1 mm (40 mils) diameter with anouter wall thickness of 0.2 mm (8 mils). The inner core composition ofboth fibers is the same; i.e. was a blend of 95 weight percent 75/25glycolide/caprolactone segmented block copolymer and 5 weight percentBaSO4. The outer shell for the first round fiber was made from a blendcontaining 60 weight percent of a copolymer of 90/10 glycolide/lactidecopolymer and 40 weight percent of 85/15 lactide/glycolide copolymer.However, the outer shell layer of the second round fibers was made from90/10 glycolide/lactide copolymer. Both fibers were annealed at 75° C.for 6 hours.

The tensile tests on the fibers were conducted using an Instron 4500 andthe fiber samples were pulled at a speed of 30.5 mm/minute and thesample length was 25.4 mm. The load at yield and the strain at yieldwere measured. For in vitro testing, the samples kept in a phosphatebuffered solution bath with a pH of 7.27 at a temperature of 37 C.Samples were removed from the bath at stated intervals and tested foryield load and yield strain.

The complete loss of yield load within 10 days of the second coextrudedround fiber (which did not have a blended material in the outer shell)demonstrates the significance of adding a lactide-rich copolymer, i.e.85/15 lactide/glycolide copolymer to the glycolide-rich copolymer, i.e.90/10 glycolide/lactide copolymer, in the first round fiber. The yieldstrain, for the first fibers with the blended material in the outershell, drops but recovers owing to the presence of the lactide-richcomponent. The lactide-rich component is likely to provide toughness tothe shell material of the first round fiber at longer in vitro exposurecompared to the shell materials in the second round coextruded fiberthat only contains glycolide-rich copolymer.

EXAMPLE 3

A process used to convert fibers having an oval or ellipticalcross-section into stents is described in this example. A stent withsingle helix structure was formed from a single oval fiber. Coextrudedfibers containing materials made in Example 1 were considered for theshell and core of the oval fiber.

The process to make oval coextruded fibers is described first. Thematerial used in the outer core and inner shell has been described inExample 1. The outer shell layer was made from a blend 60 wt % of 90/10glycolide/lactide copolymer and 40 wt % of 85/15 lactide/glycolidecopolymer. The inner layer was made from a blend of 95 wt % of 75/25glycolide/caprolactone segmented block copolymer and 5 wt. % bariumsulfate.

The oval fibers were coextruded using two single screw extruders. Bothscrews had compression ratios of 3:1 and a L/D of 25:1. A 1″ horizontalextruder was used for outer shell layer and ⅝″ vertical extruder wasused for the inner core. A concentric two-layer feed-block feeds the twomaterial stream into a single orifice die from which the extrudate isfed to a water trough for cooling. An air jet was used to remove theexcess surface moisture and an air cutter is used to cut fiber intodesired length of approximately 4 feet. A laser-micrometer was used tomeasure the fiber diameter (major and minor) on-line and a microscopewas used to ascertain the wall thickness, of the inner and outer layers.

The temperature profile of the material in the outer shell was 185, 210,222, 215, and 215° C. from rear barrel zone to die flange. The blend inthe outer shell was 60 wt % of 90/10 glycolide/lactide copolymer and 40wt % of 85/15 lactide/glycolide copolymer. The temperature profile ofthe inner core material was 215, 224, 224 and 230° C. from rear barrelzone to die flange. The material in the inner core was a blend of 95weight percent of 75/25 glycolide/caprolactone segmented block copolymerand 5 weight percent barium sulfate. A single-hole die of ovalcross-section at 213° C. was used.

The dimension of the coextruded oval fiber was 1 mm (40 mils) minordiameter and a 2 mm (80 mils) major diameter with a 0.2 mm (8 mil) outerwall thickness.

The fibers were wound on mandrels at elevated temperatures. The mandrelswere made from reinforced plastics. The shape and dimensions of themandrel is shown in FIG. 18. The winding temperature was 70 C.

The oval fiber major diameter of 80 mils and minor diameter of 40 mils)measuring 4 feet long was held and taped against mandrel at about 60 mmfrom hole B. Two metal posts (φ2×15 mm length) are inserted into theholes A and B. The mandrel and fiber were immersed in a constanttemperature water bath at 70° C. and held there for one minute. By usingappropriately positioned clamps, it was ensured the entire fiber wasunder tension while being immersed and that the fiber was guided intoclosely packed coils. The winder rotated the mandrel between 20-30 RPMto form the prostatic section.

The coiling process started from the taped point and the prostaticportion was complete when the coils reach the post at point B. The fiberwas then guided at an angle of 180° or more over the post B towardssecond post C to form the connector. The fiber was then guided at arotation of 180° or more over the post B towards second post A to formthe connector. The fiber was then guided back to a positionperpendicular to the mandrel before being coiled to form the distal loopsection of the stent.

The entire assembly, i.e. the coiled stent and the mandrel was removedfrom the bath and the unused fiber cut off and discarded. The assemblyof mandrel and stent was dried under vacuum for at least 48 hours priorto annealing.

EXAMPLE 4

The stents were annealed after they were wound. Prior to annealing, theposts or pins were removed from the mandrel. The entire assembly, ofstent wound on mandrel, was then hung in an inert gas (nitrogen)annealing oven, the oven purged and the stent annealed at 75° C. for 6hours. The stents are removed from the mandrel and stored in nitrogenbox.

EXAMPLE 5

In vitro testing on stents made in Example 4 was conducted to determinehow the stents would withstand radial stresses. The testing provided thein vitro (tested in phosphate buffered solution with pH of 7.3 andtemperature of 37° C.) compressive crush resistance test results forsingle helix stents made from oval fibers.

The prostatic coil section of a stent was cut from the whole stent andwas held between a fixed bottom plate and a movable upper plate in anInstron 1122 tensile testing machine. The top plate was moved at a speedof 2.5 mm per minute. The radial compressive stiffness and the maximumcompressive load that the coils withstood during the deformation rate of2.5 mm per minute, are shown in the table.

Table

In Vitro Radial Compressive Test for the Prostatic Coils Oval fiber with0.2 mm outer wall Radial Stiffness Max. Load Resistance Days (lbs)(lbs/inch) 0 40 2710 7 37 1505 10 27 1490 14 20 1154

Over the 14 day period, both the maximum load and stiffness decreasedwith increased in vitro exposure. Coils made from oval coextruded fiberswith 0.2 mm (8 mil) wall and having the composition described in Example3 lost their properties gradually. However, a stent made from roundcoextruded fibers having a 90/10 glycolide/lactide copolymer in theouter shell and a blend of 95 wt % 75/25 glycolide/caprolactonesegmented block copolymer and 5 wt. % barium sulfate in the inner corecollapsed with 10 days of in vitro exposure.

Compared to a typical removable catheter such as a Foley catheter thatis used to keep the uretheral lumen open, maximum load and stiffness ofstents made from oval fiber is higher than those of Foley catheters evenafter 14 days of in vitro exposure. This indicates that stents, madefrom coextruded fibers having the particular composition described inExample 4, have sufficient adequate mechanical response necessary tokeep the urethra patent and functional at least 14 days.

EXAMPLE 6

The previous example demonstrated the efficacy of stents made fromcoextruded fibers after prolonged in vitro exposure. With furtherexposure to in vitro medium, the inner core and the outer shell offibers, from which the stent is made, degrades at different rates. Theresultant morphology of the stent is obtained by observing thecross-section of the fibers under a scanning electron microscope.

The scanning electron micrographs shown in FIGS. 20A-C show thecross-section of oval fibers from stents that have undergone in vitroexposure at 14, 28 and 42 days. It is apparent that the core wasdegrading faster than the shell. The faster degrading core posses nomechanical integrity and has been slowly removed. The slower degradingshell retained fibrillar morphological structure even at longer timeperiods. The effect of the differing degradation profiles and thephysical state of the degraded polymers reduce the stent cross-sectionfrom a solid to a soft structure that increasingly appears to be hollow.The fibrillar structure will soften over time instead of breaking downinto large sharp fragments that can cause the removal and/or passage ofthe degraded stent to be clinically eventful. In a flow environment, theprogressively degrading stent can readily pass through the body lumenwithout causing obstruction, pain or discomfort.

EXAMPLE 7

A male patient is appropriately anesthetized and undergoes a prostratethermal ablation procedure using conventional laser treatment devices.After successful completion of the surgical procedure, a stent 5 of thepresent invention is inserted into the patient's urethra and bladder inthe following manner using an applicator 200: The surgeon trims thestent to size. The stent is placed at the end of the applicator. Aconventional cystoscope is inserted into the lumen of the applicator.The stent and applicator are lubricated with a water-soluble medicalgrade lubricant. A fluid reservoir is attached to the applicator as inany standard cystoscopy procedure. The stent is placed in the prostaticurethra under direct visualization using a scope. Once positionedcorrectly, the applicator is removed, leaving behind the stent in theprostatic urethra. In approximately 28 days after implantation, thestent breaks down into fibrillar structure that softens further and ispassed from the urinary tract in several soft pieces through normalurine voiding.

The stents of the present invention provide many advantages over thestents of the prior art. The advantages include: rigidity (lumenpatency) for a prescribed time; a degradation softening mechanism,whereby the stent softens into a readily passable fragment or fragments;biocompatibility; means to prevent migration; means to non-invasivelymonitor the stent and its position by X-ray. etc.

Although this invention has been shown and described with respect todetailed embodiments thereof, it will be understood by those skilled inthe art that various changes in form and detail may be made withoutdeparting from the spirit and scope of the claimed invention.

1. A stent, comprising: a distal section and a proximal section, saiddistal and proximal sections having different diameters and comprising ahelical structure having a plurality of coils, said structure having alongitudinal axis and said coils having a pitch, said structure havingan internal longitudinal passage, wherein said structure is made from afiber having a cross-section, said fiber comprising: an inner corehaving an exterior surface comprising a biodegradable polymer formedfrom monomers selected from the group consisting of lactide, glycolide,paradioxanone, trimethylene carbonate, caprolactone, and combinationsthereof, said polymer having a first degradation rate; an outer sectioncovering the exterior surface of the inner core, the outer sectioncomprising a blend of a first biodegradable polymer component and asecond biodegradable polymer component, said first polymer componentcomprising a first biodegradable polymer, wherein said firstbiodegradable polymer comprises a lactide/glycolide copolymer having atleast about 80 mole percent of polymerized glycolide, said secondpolymer component comprising a second biodegradable polymer, whereinsaid second polymer comprises a lactide-rich copolymer comprising atleast about 50 mole percent of polymerized lactide, said outer layerhaving a second degradation rate, wherein the blend comprises at leastabout 50 weight percent of the first component and at least about 5weight percent of the second component, wherein said second degradationrate of said outer section is lower than said first degradation rate. 2.The stent of claim 1, wherein the core and the outer layer of the fiberare coextruded.
 3. The stent of claim 1, wherein the polymer for theinner core comprises a polymer having a sequence selected from the groupconsisting of random, block, and segmented block sequences andcombinations thereof.
 4. The stent of claim 1 wherein the polymer forthe inner core comprise a copolymer of about 75 mole percent polymerizedglycolide and about 25 mole percent polymerized caprolactone.
 5. Thestent of claim 1, wherein the blend of the outer section comprises atleast about 50 weight percent of the first component and at least 20weight percent of the second component, wherein the blend comprisesabout 38 to about 89 weight percent of polymerized glycolide with theremainder comprising copolymerized lactide.
 6. The stent of claim 1,wherein the first component of the blend of the outer section comprisesa 10/90 lactide/glycolide copolymer, and the second component comprisesan 85/15 lactide/glycolide copolymer, wherein the blend comprises about60 weight percent of the first component and about 40 weight percent ofthe second component, wherein the blend comprises about 60 weightpercent of polymerized glycolide and about 40 weight percent ofpolymerized lactide.
 7. The stent of claim 1 wherein the fiber comprisesa substantially oval cross-section.
 8. The stent of claim 1, wherein thefiber additionally comprises a longitudinal, hollow passage.
 9. Thestent of claim 1, wherein the inner core degrades into small particles.10. The stent of claim 1, wherein the outer section degrades into afibrillar morphology.
 11. The stent of claim 1, wherein the fiber has asubstantially circular cross-section.
 12. The stent of claim 1, whereinthe helical structure is made from more than one fiber.
 13. The stent ofclaim 1, wherein the inner core additionally comprises a pharmaceuticalagent.
 14. The stent of claim 1 wherein the outer section additionallycomprises a pharmaceutical agent.
 15. The stent of claim 1, additionallycomprising a radio-opaque compound.
 16. The stent of claim 1 wherein theouter section is a coating.
 17. The stent of claim 1 wherein the outersection is a layer.
 18. The stent of claim 1 wherein the firstbiodegradable polymer further comprise a therapeutic agent.
 19. Thestent of claim 1 wherein the second biodegradable polymer furthercomprise a therapeutic agent.
 20. The stent of claim 1 wherein thediameter of said proximal section is less than the diameter of saiddistal section.
 21. The stent of claim 20 wherein said proximal sectionhas a diameter of from about 4 mm to about 12 mm and said distal sectionhas a diameter of from about 6 mm to about 25 mm.
 22. The stent of claim20 wherein said proximal section has a diameter of about 8 mm and saiddistal section has a diameter of about 18 mm.